January 17, 2019

A Vanderbilt cancer expert answers questions about how to get a second opinion for cancer.

You’ve just been diagnosed with cancer. Your doctor has talked to you about a treatment plan, but you’re not sure if it’s the right option for you. Yet you wonder how to get a second opinion for your cancer diagnosis and treatment recommendations.

Don’t hesitate. Getting a second opinion can make a big difference. We talked with Michael Neuss, M.D., of the Vanderbilt-Ingram Cancer Center, about how to get a second opinion for cancer and some common questions and concerns.

What are the benefits of getting a second opinion for a cancer diagnosis?

There are many benefits to getting a second opinion in almost all cases where something as serious as cancer has been diagnosed. First, a fresh set of eyes reviews the details of your diagnosis, additional information relative to features such as molecular tumor characteristics and cancer stage, and your approach to this illness. This second point of view most often validates and supports the first doctor’s plan. Rarely, but importantly, it sometimes brings a new understanding that may lead to a therapeutic plan. This may be more appropriate for you either because of the diagnostic details or your beliefs and approach to an illness. Because of the way research studies are managed, a second opinion can also provide access to unique treatments that the first physician may not have available.

Second opinions do afford the possibility of creating some confusion — if the second opinion is very different from the first, you may need a “tiebreaker.”

How can I decide if a second opinion is right for me?

If you’re feeling that communication with your doctor is somehow just not right and want reassurance that the plan is a good one, it’s reasonable to get a second opinion. Also, sometimes a third-party observer — a case manager nurse at an insurance company or your family physician — recommends this. Those recommendations should be taken seriously. It is only wrong to get a second opinion if the delay in getting this puts you at risk. Even then, the physician treating you should be able to come up with a way to get outside input on your circumstances.

Will my doctor be upset if I want another opinion?

No oncologist should be upset if you want another opinion. In fact, it’s quite the opposite — a good doctor should welcome the input because they too want to get you exactly what’s right.

How do I find another doctor?

The physician you’re seeing should be able to recommend a second opinion and make arrangements for it to happen. If they are reluctant or unable to do this, you can seek out an opinion at a nationally recognized program such as at a National Cancer Institute-designated cancer center.

What will a second opinion about cancer cost me?

It varies greatly. Most insurance plans will cover this, but your copay may vary, from nothing to several hundred dollars. You should be able to ask this question of either your insurance company or the institution or doctor who will be seeing you for the second opinion.

How should I prepare for the second opinion?

You may need to help gather information to send or bring to your second opinion. Often the doctor or hospital you are seeing for the second opinion will request slides, X-ray files or other materials. You may be asked to go to where the tests were performed and sign a release, or pay for shipping of these materials.

What questions should I ask the second doctor?

You should ask questions that you want answered. Usually, those are:

  1. What do I need to do?
  2. What’s likely to happen to me?
  3. Do you agree with the other physician’s recommendations?

What if the cancer diagnosis or treatment plans vary between doctors?

It’s important to realize that this happens only rarely, but it is a possibility. If it does occur, you should go with your instincts and consider a third (tiebreaker) opinion at an NCI-designated or a National Comprehensive Cancer Network member cancer center.

Learn more about National Cancer Institute-designated cancer centers and centers that are part of the National Comprehensive Cancer Network.

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The Vanderbilt-Ingram Cancer Center is a national leader in patient care and research. Vanderbilt offers the region’s most complete range of oncology care, from advanced imaging to team-based treatment options to genetic cancer medicine and the latest in therapies being studied in clinical trials.

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